Why Did I go Mad? was the arresting title of Tuesday’s night’s Horizon programme in which three people with psychosis spoke frankly about their illness. Paranoia, hallucinations, hearing voices – not so long ago it would have been unthinkable to have sufferers describing these to a television audience; we saw one of them shrinking from a spiky crab-like monster which appeared at his table as he sat in a coffee shop; another drew her persecuting voices as tree-like horrors who constantly threatened her with violence.
I thought of the poignant incident in the New Testament where a tormented man was asked his name and replied, ‘Legion’ explaining ‘for we are many’. Ancient cultures knew how mental illness can fragment the personality.
What was remarkable about the programme was the way it brought together two approaches to psychosis which have often been in conflict. The strictly medical way has been to treat it as an organic disease. The current theory is that too much of the brain chemical dopamine can trigger it, though there are genetic and social aspects as well. But there has always been an alternative approach, closer perhaps to a pre-scientific understanding, that asks: What are the voices saying; what do the monsters signify? It’s an issue of how to define truth. In the 1960s the counter-cultural psychiatrist R.D. Laing hailed schizophrenics as prophets, while others insisted that patients should be told firmly that they could never be cured until they accepted that their voices and visions were unreal. Both sides accused the other of harming patients; either by refusing to recognise the seriousness of their suffering or by refusing to see meaning in their symptoms. In the programme we saw one sufferer’s medicine chest with its box of proven anti-psychotic drugs; but we also heard of gentler interventions; of the Hearing Voices network which supports people who experience voices.
Treating our bodies as machines works well for many illnesses; the whole person gets better as the mechanism is mended. But mental illness doesn’t always follow this pattern. Psychosis seems to open an underground chasm in the self; what spills out may be terrible and destructive or potentially valuable. One of the voice hearers in the Horizon programme said, quite casually, that she now realised that her voices were simply a part of herself. Another was shown starting a dialogue with one of her persecuting voices. For some there is clearly a point in trying to find meaning in madness. When I look at the healings Jesus performed in the New Testament; mind, body and meaning were all involved.
Perhaps mental health is beginning to heal some of the splits in its own thinking and to recognise the key place metaphor and symbol play in human health. We no longer shut the mentally ill away from society. In mental illness truth is more than fact or fiction.”
You can listen to the broadcast here
Canon Angela Tilby, Thought For The Day, BBC Radio 4, 04/05/17